Provider Demographics
NPI:1942705827
Name:YOUNG, AARON THOMAS
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:THOMAS
Last Name:YOUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 ALLISON DR APT 7102
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-5048
Mailing Address - Country:US
Mailing Address - Phone:949-239-9660
Mailing Address - Fax:
Practice Address - Street 1:1360 BURTON DR STE 160
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3560
Practice Address - Country:US
Practice Address - Phone:707-446-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-24
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA184848207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology